Typhoid Fever due to Extended Spectrum β-Lactamase-Producing Salmonella enterica Serovar Typhi: A Case Report and Literature Review

Emergence of cephalosporin-resistant strains of Salmonella enterica serovar Typhi is a cause of concern in the management of enteric fever. Cephalosporin resistance in Salmonella species is mainly due to the production of extended-spectrum β-lactamases (ESBLs). The majority of ESBLs in Salmonella enterica serovar Typhi are derivatives of the TEM, SHV, and CTX-M β-lactamase families. Of these, CTX-M appears to be predominant. This paper discusses the detection and molecular characterization of an ESBL-producing Salmonella enterica serovar Typhi strain isolated from a patient who was admitted to a private hospital in Sri Lanka. The three main types of β-lactamases such as TEM, SHV, and CTX-M were identified in this isolate. This case report from Sri Lanka contributes to the knowledge of the increasingly reported cases of typhoid fever due to Salmonella enterica serovar Typhi resistant to β-lactamase by ESBL production.

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Plasmid-Mediated Resistance to Cephalosporins in Salmonella enterica Serovar Typhi

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00225-10 ◽

2010 ◽

Vol 54 (9) ◽

pp. 3991-3992 ◽

Cited By ~ 9

Author(s):

Masatomo Morita ◽

Nobuko Takai ◽

Jun Terajima ◽

Haruo Watanabe ◽

Manabu Kurokawa ◽

...

Keyword(s):

Salmonella Enterica ◽

Salmonella Enterica Serovar Typhi ◽

Extended Spectrum ◽

Cephalosporin Resistance

ABSTRACT This study characterized a cephalosporin-resistant Salmonella enterica serovar Typhi isolate. The organism possessed a plasmid encoding the CTX-M-15 extended-spectrum-β-lactamase. This plasmid is the determinant for the phenotype of cephalosporin resistance and is transferrable among Enterobacteriaceae.

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Case Report: Near-Fatal Intestinal Hemorrhage and Acute Acalculous Cholecystitis due to Vi-Negative and Fluoroquinolone-Insensitive Salmonella enterica Serovar Typhi Infection: A Rare Entity

Frontiers in Medicine ◽

10.3389/fmed.2021.666643 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yuehua Gong ◽

Jianlin Li ◽

Dongnan Zhu ◽

Songsong Wang ◽

Yingchun Xu ◽

...

Keyword(s):

Case Report ◽

Typhoid Fever ◽

Salmonella Enterica ◽

Rare Condition ◽

Acalculous Cholecystitis ◽

Acute Acalculous Cholecystitis ◽

Rare Entity ◽

Adult Case ◽

Salmonella Enterica Serovar Typhi ◽

Intestinal Hemorrhage

Typhoid fever is usually a mild clinical disease. Typhoid fever with massive intestinal hemorrhage is rare in the antibiotic era. Acute acalculous cholecystitis (AAC) is also rare in adults. Here, we describe the first adult case of typhoid fever with both complications due to Vi-negative and fluoroquinolone-insensitive Salmonella enterica serovar Typhi (S. Typhi) infection. We aim to alert physicians to this rare condition.

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A Case Report of a Typhoid Fever Outbreak with an Uncommon Vehicle and Source of Salmonella Enterica Serotype Typhi

Journal of Clinical Case Studies Reviews & Reports ◽

10.47363/jccsr/2020(3)164 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1-3

Author(s):

Douglas W Mushi ◽

Keyword(s):

Case Report ◽

Typhoid Fever ◽

Salmonella Enterica ◽

Endemic Region ◽

Salmonella Enterica Serovar Typhi

Two goat caretakers aged 19 and 25 years old were infected with Salmonella enterica serovar typhi (S. typhi); both had eaten raw carrots from a garden enriched with goat faeces in typhoid endemic region of Morogoro, Tanzania. S. typhi strains isolated from garden soils and carrots proved to be from goat faeces. This data provide evidence for the spread of typhoid fever through carrots contaminated by faeces from goats contained transient S. typhi.

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Genomic Dissection of Travel-Associated Extended-Spectrum-Beta-Lactamase-Producing Salmonella enterica Serovar Typhi Isolates Originating from the Philippines: a One-Off Occurrence or a Threat to Effective Treatment of Typhoid Fever?

Journal of Clinical Microbiology ◽

10.1128/jcm.03104-14 ◽

2014 ◽

Vol 53 (2) ◽

pp. 677-680 ◽

Cited By ~ 9

Author(s):

Rene S. Hendriksen ◽

Pimlapas Leekitcharoenphon ◽

Matthew Mikoleit ◽

Jacob Dyring Jensen ◽

Rolf Sommer Kaas ◽

...

Keyword(s):

Typhoid Fever ◽

Salmonella Enterica ◽

The Philippines ◽

Whole Genome Sequence ◽

Whole Genome ◽

Beta Lactamase ◽

Content Type ◽

Extended Spectrum Beta Lactamase ◽

Salmonella Enterica Serovar Typhi ◽

Extended Spectrum

One unreported case of extended-spectrum-beta-lactamase (ESBL)-producingSalmonella entericaserovar Typhi was identified, whole-genome sequence typed, among other analyses, and compared to other available genomes ofS. Typhi. The reported strain was similar to a previously published strain harboringblaSHV-12from the Philippines and likely part of an undetected outbreak, the first of ESBL-producingS. Typhi.

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Regulation of the gastrointestinal epithelial cell expression of CFTR protein by Salmonella enterica serovar Typhi, and its importance to infection and development of typhoid fever

Gastroenterology ◽

10.1016/s0016-5085(01)83516-2 ◽

2001 ◽

Vol 120 (5) ◽

pp. A706-A706

Author(s):

J LYCZAK ◽

G PIER

Keyword(s):

Epithelial Cell ◽

Typhoid Fever ◽

Salmonella Enterica ◽

Salmonella Enterica Serovar Typhi ◽

Cftr Protein ◽

Cell Expression

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Characterization of the multidrug efflux transporter styMdtM from Salmonella enterica serovar Typhi

Proteins Structure Function and Bioinformatics ◽

10.1002/prot.26141 ◽

2021 ◽

Author(s):

Aqsa Shaheen ◽

Fouzia Ismat ◽

Mazhar Iqbal ◽

Abdul Haque ◽

Zaheer Ul‐Haq ◽

...

Keyword(s):

Salmonella Enterica ◽

Efflux Transporter ◽

Multidrug Efflux ◽

Salmonella Enterica Serovar Typhi

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Emergence of Resistance Mutations in Salmonella enterica Serovar Typhi Against Fluoroquinolones

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx230 ◽

2017 ◽

Vol 4 (4) ◽

Cited By ~ 5

Author(s):

Takashi Matono ◽

Masatomo Morita ◽

Koji Yahara ◽

Ken-ichi Lee ◽

Hidemasa Izumiya ◽

...

Keyword(s):

Salmonella Enterica ◽

Evolutionary Process ◽

Resistance Mechanisms ◽

Single Mutation ◽

Nucleotide Polymorphisms ◽

Resistance Mutations ◽

Single Nucleotide ◽

Salmonella Enterica Serovar Typhi ◽

Resistant Strains ◽

Emergence Of Resistance

Abstract Background Little is known about the evolutionary process and emergence time of resistance mutations to fluoroquinolone in Salmonella enterica serovar Typhi. Methods We analyzed S. Typhi isolates collected from returned travelers between 2001 and 2016. Based on ciprofloxacin susceptibility, isolates were categorized as highly resistant (minimum inhibitory concentration [MIC] ≥ 4 μg/mL [CIPHR]), resistant (MIC = 1–2 μg/mL [CIPR]), intermediate susceptible (MIC = 0.12–0.5 μg/mL [CIPI]), and susceptible (MIC ≤ 0.06 μg/mL [CIPS]). Results A total of 107 isolates (33 CIPHR, 14 CIPR, 30 CIPI, and 30 CIPS) were analyzed by whole-genome sequencing; 2461 single nucleotide polymorphisms (SNPs) were identified. CIPS had no mutations in the gyrA or parC genes, while each CIPI had 1 of 3 single mutations in gyrA (encoding Ser83Phe [63.3%], Ser83Tyr [33.3%], or Asp87Asn [3.3%]). CIPHR had the same 3 mutations: 2 SNPs in gyrA (encoding Ser83Phe and Asp87Asn) and a third in parC (encoding Ser80Ile). CIPHR shared a common ancestor with CIPR and CIPI isolates harboring a single mutation in gyrA encoding Ser83Phe, suggesting that CIPHR emerged 16 to 23 years ago. Conclusions Three SNPs—2 in gyrA and 1 in parC—are present in S. Typhi strains highly resistant to fluoroquinolone, which were found to have evolved in 1993–2000, approximately 10 years after the beginning of the ciprofloxacin era. Highly resistant strains with survival advantages arose from strains harboring a single mutation in gyrA encoding Ser83Phe. Judicious use of fluoroquinolones is warranted to prevent acceleration of such resistance mechanisms in the future.

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